NPIMap

Organization Active NPI

St. Luke's Warren Physician Group, PC

  • Colon & Rectal Surgery Physician
  • Phillipsburg, NJ
National Provider Identifier
1043635733
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
123 Roseberry St
Phillipsburg, NJ 08865-1629
Phone
(610) 866-2600
Fax
(610) 861-7640
NPI assigned
Mar 4, 2014
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Gerard J Delmonico, MDNPI 1184683690
Title
Owner
Phone
(908) 859-6568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X Primary

Addresses

Primary practice location

123 Roseberry St
Phillipsburg, NJ 08865-1629

Mailing address

PO Box 27957
Salt Lake City, UT 84127-0957
Phone (908) 835-1910

Other identifiers 1

IdentifierTypeStateIssuer
7123604MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000020 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 664 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belvidere, NJ; Washington, NJ; Phillipsburg, NJ; Hampton, NJ; Clinton, NJ

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1043635733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27957",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270957",
            "telephone_number": "908-835-1910",
            "fax_number": "908-835-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ROSEBERRY ST",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088651629",
            "telephone_number": "610-866-2600",
            "fax_number": "610-861-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "DELMONICO",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-859-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7123604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.